Journal article
Emergency department admissions to inpatient cardiac telemetry beds: a prospective cohort study of risk stratification and outcomes
The American journal of medicine, Vol.110(1), pp.7-11
2001
DOI: 10.1016/S0002-9343(00)00640-9
PMID: 11152858
Abstract
Purpose: Little is known about physicians’ use of inpatient cardiac telemetry units among emergency department patients at risk for cardiac complications. We therefore studied the outcomes of patients admitted to inpatient telemetry beds to identify a subset of patients from whom cardiac monitoring could be withheld safely.
Subjects and Methods: We conducted a prospective cohort study of 1,033 consecutive adult patients admitted to an inpatient telemetry unit from the emergency department of a 700-bed urban public teaching hospital. Subjects with or without chest pain were risk-stratified using a prediction rule and observed for in-hospital cardiac complications, acute myocardial infarction, and transfer to an intensive care unit (ICU).
Results: There were no significant differences between patients with (n = 677) or patients without chest pain (n = 356) in the rates of major cardiac complications, myocardial infarctions, or transfers to an ICU. Among 318 patients with chest pain who were classified as being very low risk, none suffered major complications (negative predictive value 100%; 95% confidence interval [CI]: 98.8% to 100%). Among 214 very low risk patients without chest pain, 1 (0.5%) had a major complication (negative predictive value 99.5%; 95% CI: 97.4% to 99.9%).
Conclusions: The prediction rule accurately identified patients with or without chest pain who were at very low risk of major complications, identifying a subset from whom cardiac monitoring could be withheld safely.
Details
- Title: Subtitle
- Emergency department admissions to inpatient cardiac telemetry beds: a prospective cohort study of risk stratification and outcomes
- Creators
- Lakshmi Durairaj - Department of Medicine, Cook County Hospital and Rush Medical College, Chicago, Illinois,USABrendan Reilly - Department of Medicine, Cook County Hospital and Rush Medical College, Chicago, Illinois,USAKrishna Das - Department of Medicine, Cook County Hospital and Rush Medical College, Chicago, Illinois,USAChristopher Smith - Department of Medicine, Cook County Hospital and Rush Medical College, Chicago, Illinois,USAChristine Acob - Department of Medicine, Cook County Hospital and Rush Medical College, Chicago, Illinois,USAShahid Husain - Department of Medicine, Cook County Hospital and Rush Medical College, Chicago, Illinois,USAMohammed Saquib - Department of Medicine, Cook County Hospital and Rush Medical College, Chicago, Illinois,USAPamela Ganschow - Department of Medicine, Cook County Hospital and Rush Medical College, Chicago, Illinois,USAArthur Evans - Department of Medicine, Cook County Hospital and Rush Medical College, Chicago, Illinois,USARobert McNutt - Department of Medicine, Cook County Hospital and Rush Medical College, Chicago, Illinois,USA
- Resource Type
- Journal article
- Publication Details
- The American journal of medicine, Vol.110(1), pp.7-11
- Publisher
- Elsevier Inc
- DOI
- 10.1016/S0002-9343(00)00640-9
- PMID
- 11152858
- ISSN
- 0002-9343
- eISSN
- 1555-7162
- Language
- English
- Date published
- 2001
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
- Record Identifier
- 9984094634402771
Metrics
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